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Illegal immigrants strain health system

Published on: 06/01/06
If you ask Americans what bugs them most about illegal immigration, you're likely to hear how the casual flouting of the law seems to have generated a bipolar, wink-and-nod response from government agencies.

On one hand, the federal government is supposed to have established hard and fast rules about who gets in and who doesn't, but, on the other, the government routinely lets those who disobey the rules get many of the benefits of citizenship.

In public schools, the courts have ruled that local districts must educate children under the age of 16, regardless of their immigration status. Similarly, taxpayer-supported hospitals must treat anyone coming through the door with a medical emergency, even if they can't pay for treatment.

Over the last decade or so, that open-door policy has resulted in state government agencies around the country that look the other way when illegal immigrants showed up needing food stamps or routine social and health services. In recent years, illegal immigrants in Georgia have been able to access Medicaid services that were supposed to be reserved for poor Georgians.

The rules governing the jointly funded federal and state health insurance program have, for 10 years, limited who qualifies for most Medicaid services to citizens and those foreign nationals in the country legally. But rather than require proof of citizenship, hospitals and other health care providers often billed Medicaid for the services and asked questions later. Finally, last January, after pressure from federal officials, state Medicaid officials started enforcing the rules.

Predictably. hospitals, cancer clinics and dialysis centers that had gotten used to billing Medicaid for services they provide to illegal immigrants are now howling. Children's Healthcare of Atlanta, which has two hospitals and serves the area with some of the best pediatric care money can buy, has said it has already absorbed $800,000 this year in costs for treating illegal immigrants who were once covered by Medicaid. Nearly half of the 172 illegal immigrant children it continues to treat are receiving cancer treatment. Without it, those children might relapse and die.

And that's the harsh reality of the bipolar system we have created for dealing with illegal immigration. Providing ongoing care to people with cancer, diabetes, high blood pressure and kidney failure is much more cost effective than waiting for them to need emergency hospitalization. In the long run it saves lives, not just money.

Advocates point out that having Medicaid pay the bills for illegal immigrants is a pittance, compared to the total cost of the program. Truth is, no one really knows how much is being spent on them. The $112 million Georgia budgeted this year for emergency services for illegal immigrants is probably a fraction of the real cost.

But here's a figure we do know: Medicaid is a $7.4 billion program in Georgia. It is growing faster than any other state spending item. Nearly every year, the state has to consider reducing Medicaid rolls or restricting some services in order to afford to keep the program going. To balance the budget, families of children with severe disabilities covered by Medicaid have been asked to pay more out of their own pockets. Other costly programs remain in constant jeopardy.

Ignoring the rules and allowing, by default, thousands of illegal immigrants and their children into this essential program is not an option. It is simply unfair to poor, legal Georgia residents who depend on the government program.

So what happens to those immigrants who need the medical care but can't afford it?

The new state immigration law allows county health departments to deliver basic medical services — immunizations to children, prenatal care for pregnant women — to illegal immigrants and their families. Adults with communicable diseases can also be treated at local health clinics regardless of their immigration status.

For most other medical services, undocumented immigrants will have to rely on charity care, either provided by the physician, hospitals or clinic dispensing the service. Foundations and faith-based groups should also realize that government programs can no longer shoulder this burden and step up fund raising to help defray the costs.

Critics of illegal immigration should also be willing to help. These folks have often been unfairly labeled anti-immigrant, or worse, because of their demands for reform. While they are correct to insist government regulations regarding coverage be respected, they would do well to advocate for private funding for needed medical services to those immigrants already here.

•Mike King is a member of the editorial board. His column runs Thursdays.